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The Journal of the Royal Institute of Thailand Vol. 33 No. 2 Apr.-Jun. 2008 82 °≈ÿà ¡‚√§Õâ «π≈ßæÿ ß (Metabolic Syndrome) Abstract Metabolic Syndrome Nibha Jaroonvesama Fellow of the Academy of Science, The Royal Institute, Thailand Metabolic syndrome is a group of abnormalities which cause risks of cardiovascular disease. These abnormalities are abdominal obesity, dyslipidemia, hypertension and resistance to insulin-stimulated glucose uptake (insulin resistance) including prothrombotic and proinflammatory states. Patients who have metabolic syndrome will have chances to have diabetes mellitus type II and cardiovascular disease. At present the etiologies of metabolic syndrome are the results of abdominal obesity and insulin resistance. Excess fat from abdomen will release free fatty acid or nonesterified fatty acid (NEFA) which will cause insulin resistance followed by hyperinsulnemia and glucose intolerance. These NEFA can go freely to the liver, then dyslipidemia, fatty liver, nonalcoholic steatohepatits and hepatic gluconeogensis are developed and reduced adeponectin from the liver which associates to insulin resistance is observed. The causes of hypertension in this syndrome are insulin resistance and hyperinsulinemia which stimulate sympathetic nervous system activity. Excess of NEFA will stimulate production of cytokine tumor necrosis factor-? and plasminogen activator inhibitor, so proinflammatory state and prothrombotic state will be developed respectively. The first priority of treatment of metabolic syndrome is life style modification by reduction of body weight by changing behavior of eating and regular physical exercise. After the patients have tried as mentioned but are not successful then drug treatment will be advised. The recommended drugs are dependent on the abnormalities: metformin and thaizolidinedione can lower the level of insulin resistance and prevent development of diabetes mellitus type II in metabolic syndrome patients, and drugs for treatment of dyslipidemia and hypertension are also prescribed. Key words: abdominal obesity, insulin resistance, hyperglycemia, hypertension, dyslipidemia